'Woeful' decline in GP placements

GP placements for foundation doctors are under threat, an investigation by GP has found.

The Committee of General Practice Education Directors (COGPED) is so worried at the relative loss of placements that it has asked Professor Justin Allen, primary care adviser to the DoH's Foundation Programme, to count placements in all deaneries.

Dr Bill Reith, chairman of the RCGP's postgraduate training board, said that as numbers of foundation doctors rise, the proportion of GP placements is dropping 'woefully'.

In Wales, Northern Ireland and parts of Scotland only 25 per cent of F2 doctors work in general practice.

In Severn deanery the figure is 39 per cent. The next lowest are Oxford (50 per cent) and West Yorkshire and West Midlands (both 53 per cent).

Dr Reith said: 'This is a concern. We know that once foundation doctors have seen what general practice is like, they increasingly realise that work is being transferred into the community.'

Some deaneries supplement GP placements with community slots. Peninsula deanery in the south west of England has an alternative placement for 17 per cent of its F2 doctors and 45 per cent in general practice.

Space in general practice is part of the problem, said Dr Anne Edwards, Foundation School director at Oxford deanery. 'GPs can't accommodate the F2 doctors now that VTS training in general practice is longer. It's a serious problem.'

The DoH in England has already backtracked on promises of GP placements for foundation doctors. In 2005 it pledged placements for all, triggering a letter of thanks from COGPED. By 2006 it dropped its commitment to 55 per cent.

Dr Edwards said that now the need for the placements has vanished. 'GP pay is so much higher we don't need to encourage recruitment into general practice.'

But she warned that doctors in training could desert general practice.

'People will desert general practice soon because there are no opportunities for partners, nurses are doing the work that GPs did and there are aspects of the service, such as out-of-hours, that doctors aren't happy with.'